Javier, Aimie .

HRN: 23-71-26  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/15/2023
CEFTRIAXONE 1G (VIAL)
09/15/2023
09/21/2023
IV
2g
Q24h
UTI
Checking Final Appropriateness 
09/16/2023
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
09/16/2023
09/22/2023
IV
1.5gm
Q6
Elevated WBC
Checking Final Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: